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Women who were born without a uterus or lost it as a result of cancer will be able to fulfill their dreams of motherhood. The desire to have your own child is the most important thing in life for many. A uterine transplant may be an opportunity.
The uterus is an organ without which one can live. It is transplanted primarily so that a woman can give birth to a child. In women who have never given birth, this organ is about 7 cm long, about 4 cm wide and about 2,5 cm thick. During pregnancy, its capacity increases several hundred times. – In the case of the uterus, we cannot speak of a life-saving transplant, as in the case of the heart or the kidney. But the psychological side of a woman’s life, the willingness to be fit in the full sense of the word, is disturbed with a non-functional uterus. That is why medicine is looking for solutions that will be able to remedy this – explains prof. Mariusz Bidziński, head of the Clinical Department of Gynecology at the Świętokrzyskie Cancer Center.
Successful uterine transplants
Uterine transplantation is an opportunity for women who would like to be mothers, but who have lost an organ as a result of a cancer – such as cervical cancer. It can be carried out after several years of follow-up, when there is no indication that the disease has recurred. Transplantation is also a solution for women who were born without this organ. Of course, several elements must be met – a woman cannot be burdened with additional diseases, e.g. diabetes. Successful uterine transplants have so far been isolated cases. They were conducted in Sweden, Saudi Arabia and Turkey. – To talk about success, a surgeon or a gynecologist is not enough. You also need an immunologist, a person dealing with molecular medicine and many other specialists – explains Prof. Bidziński. The most advanced research in this field is carried out in Sweden. There is a large research group there, over 20 doctors of various specialties. Last year, two 30-year-old female patients were implanted with uteri taken from the mothers of both women. One of them was born without this organ, the other lost her uterus during anti-cancer treatment. The transplants took hold. Now British scientists have announced that in two years they will be able to transplant this organ, thanks to which the patient will be able to give birth to a healthy child.
Problem with conception
As emphasized by prof. Bidziński, women with a transplanted uterus have a chance of having a baby, but getting pregnant naturally can be difficult. – If everything is fine – the uterus is adequately supplied with blood, it is working properly, then of course it is possible to give birth to a child. However, it can be very difficult to get pregnant naturally. Given the number of very discrete mechanisms that would be required for natural conception to occur, such as fallopian tube fixation, it would be more advisable to collect the egg, fertilize it in vitro and then introduce it into the uterus. The transplanted uterus would act as an incubator, she explains. However, it should also be remembered that transplantation is not always possible. An active neoplastic disease is a contraindication to the procedure. In addition, all kinds of disorders in the field of metabolic diseases, e.g. diabetes, but also immunosuppression and diseases that lead to permanent damage to the vascular system. They can decide whether the transplant is successful or not.
In patients with these conditions, there is a greater risk of organ rejection. Transplanted organs often become rejected after some time. As of today, the observations are too short to say whether the transplanted uterus ceases to function after some time. However, if it had served its purpose sooner, it could be removed later. However, if there are no pathological changes in the transplanted uterus, there is no point in depriving the woman of this organ after the procreation period is over.
When is the uterus transplant in Poland?
There are many patients who would decide to undergo a uterine transplant in Poland. There would certainly be donors as well. – I know two families where, when daughters had to be uterus-depleted, their mothers immediately offered to donate their uterus so that their children could also have children – says the gynecologist. However, when asked whether it is possible to perform such a procedure in Poland, he replies that we do not have experience in this field yet. – The doctors from Sweden are the most advanced in this matter. Except that the uterine transplant surgery is not commercially there yet. At the moment it is treated as an experimental developmental study. The Polish women I mentioned expressed their willingness to join this program – he explains. According to the professor, in the future, uterine transplants will become more popular and will be a hope for motherhood for women who do not have a uterus and would like to be mothers. – Transplantology is constantly developing. Of course, everything still needs to be standardized both in terms of technology and formal and legal. After all, it is necessary to determine from whom this organ can be harvested for transplant, or from deceased or only relatives. Stem cells and growing organs from them are another element worth considering in this case. Perhaps it will be easier, faster and cheaper to grow a uterus from your own stem cells. Then the value of the organ is also much greater. We have all the histocompatibility antigens and the risk of rejection is much lower. It is certainly the future, but it is difficult to say whether it is close – 2-3 years, or a little more distant – over a dozen years – he says.
Ask an expert
Women interested in this topic can, via the www.jestemprzytobie.pl program, ask experts questions and exchange experiences with others in a similar situation. The program I am with you and the website www.jestemprzytobie.pl helps women suffering from genital cancer and their relatives. It includes the necessary information on the prevention, diagnosis and treatment of cancers of the reproductive organs (cervical cancer, vulvar cancer, ovarian cancer, endometrial cancer) and advice on where to look for psychological support.
the program is co-created by 4 non-governmental organizations: Fundacja Różowa Konwalia im. prof. Jana Zieliński, the MSD Foundation for Women’s Health, the Polish Association of Oncology Nurses and the National Organization for the Fight against Cervical Cancer, Flower of Femininity.
Tekst: Halina of Pilon
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